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May 8, 2013 PNC HealthCare

May 8, 2013 PNC HealthCare



Grace-Marie Turner's May 8, 2013 presentation to the PNC HealthCare 2013 Spring Healthcare Advisory Panel.

Grace-Marie Turner's May 8, 2013 presentation to the PNC HealthCare 2013 Spring Healthcare Advisory Panel.



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    May 8, 2013 PNC HealthCare May 8, 2013 PNC HealthCare Presentation Transcript

    • A not-for-profithealth and tax policyresearch organization/GalenInstitutewww.galen.orgUpdate onHealth ReformGrace-Marie TurnerMay 8, 2013PNC HealthCare2013 Spring Healthcare Advisory BoardPhiladelphia
    • Americans agreed on goals for health reform…• The U.S. needs health reform to:– make coverage more affordable– assure quality, and– expand access to insurance• Most people rate their own coverage asgood or excellent• They want stability. Change was forothers.www.galen.org
    • but many say the ACA changes too much• 36% of Americans now view theAffordable Care Act favorably• 42% view the law unfavorably• Cost continues to be the biggestconcernwww.galen.orgKaiser Health Tracking Poll, February 2013. http://www.kff.org/kaiserpolls/upload/8251-F.pdf
    • www.galen.org
    • Americans’ views of health lawafter Supreme Court decision• Americans say it will make things worse ratherthan better for– taxpayers– businesses– doctors– and those who currently have health insurance.Sources: “Americans: Healthcare Law Helps Some, Hurts Others ,” Gallup, July 16, 2012, http://www.gallup.com/poll/155726/Americans-Healthcare-Law-Helps-Hurts-Others.aspx?utm_source=add%2Bthis&utm_medium=addthis.com&utm_campaign=sharing#.UARkmBS6osE.twitter. The New York Times/CBSNews Poll, July 11-16, 2012, http://s3.documentcloud.org/documents/402362/jul12a-ocr.pdf. “Kaiser Health Tracking Poll,” The Kaiser Family Foundation, July2012, http://www.kff.org/kaiserpolls/upload/8339-C.pdf
    • Why the ACA isn’t settled 38% of Americans supported the law in thelast major poll before the November elections Of the 50.6% who voted for PresidentObama…12% said they wanted the law repealedThe election was not about health reformSource: “Kaiser Health Tracking Poll: October 2012,” The Henry J. Kaiser Family Foundation, October 31, 2012,http://www.kff.org/kaiserpolls/8381.cfm.
    • NOTE: Don’t know/Refused answers not shown.SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted March 5-10, 2013)Majority Say They Don’t Understand HowACA Will Impact Them, Including Two-Thirds of Uninsured and Low-IncomeDo you feel you have enough information about the health reform law to understand how it will impact youpersonally, or not?30%33%41%68%67%57%Household income lessthan $40,000Uninsured (under age 65)TotalYes, have enough information No, do not have enough information
    • Source: Avik Roy, “Fact-Checking the Obama Campaigns Defense of its $716 Billion Cut to Medicare,” Forbes: The Apothecary, August 16, 2012,http://www.forbes.com/sites/aroy/2012/08/16/fact-checking-the-obama-campaigns-defense-of-its-716-billion-cut-to-medicare/.The health law in one graph
    • The paperwork mazeCourtesy of The Wall Street Journal at www.opinionjournal.com
    • Source: Sarah Kliff, “Is ObamaCare too much work for the Obama administration?” The Washington Post, November 12, 2012,http://www.washingtonpost.com/blogs/wonkblog/wp/2012/11/12/is-obamacare-too-much-work-for-the-obama-administration/.An ACA State Exchange
    • Do you qualify for subsidies?Source: Sen. John Cornyn, Facebook, March 22, 2013,http://www.facebook.com/photo.php?fbid=10151499130834424&set=a.112318184423.92543.75755694423&type=3&l=83fcd3ca01&permPage=1
    • The Red Tape Tower
    • Source: “Health Reform Poses Biggest Challenges to Companies with the Most Part-Time and Low-Paid Employees,” Mercer LLC, August 8, 2012,http://www.mercer.com/press-releases/1472805.Mercer: Employers planning workforce changesw Mercer study on what employers expect
    • SCOTUS SuccessBoot CampEmployers and health coverage1. Employers with <50 FTE EE’s have no3k/2k penalty2. But employers offering qualified andaffordable coverage may actually behurting their employeesExample
    • Generous Subsidies inExchangesExamples:• A person earning $42,000 a year with a familyof 4 qualifies for $14,759 in new healthinsurance subsidies• A single person earning $20,600 qualifies for$5,156 in new health insurance subsidiesBut only if employer doesn’t offer coverage or ifit’s not “affordable” (ie costs >9.5% of income)www.galen.org
    • Cost of Insurance, Family of 4
    • Impact of new rating rulesJames T. O’Connor, Milliman, for America’s Health Insurance Plans. Comprehensive Assessment of ACA Factors That Will Affect Individual MarketPremiums in 2014. http://www.ahip.org/MillimanReportACA2013/ Accessed 4-26-13
    • New and higher TaxesSource: Philip Dittmer and William McBride, “Obamacares New Taxes, And How You May Be Affected,” Tax Foundation, July 5, 2012,http://taxfoundation.org/blog/obamacares-new-taxes-and-how-you-may-be-affected.
    • More new and higher TaxesSource: Philip Dittmer and William McBride, “Obamacares New Taxes, And How You May Be Affected,” Tax Foundation, July 5, 2012,http://taxfoundation.org/blog/obamacares-new-taxes-and-how-you-may-be-affected.
    • www.galen.orgSome realities:
    • What we know for sure• CHOICE: Americans value innovation,diversity and choice to accommodate 300million people• VALUE IN HEALTH SPENDING: To realizethe promise of personalized medicine andachieve overall cost saving, break downpayment silos• FOCUS ON THE PATIENT: They wantdoctors and patients, not government, tomake health care decisions
    • A market-based solution“Defined contributions” for health coverageA system that puts doctors and patients in charge ofmedical decisionsRestructuring financing for a 21st century healthsector• Medicare• Medicaid• Private Insurance
    • States have a big roleSeek ways improve their markets• Enhance competition for more choices ofaffordable coverage• Better safety net with functional high-riskpools• Private exchanges?www.galen.org
    • www.galen.orgHealth insurance market
    • 2013 questions• Will Exchanges be ready by Oct 1?• Will there be bi-partisan support for delay?• Will people enroll after they see cost?• Will the number of uninsured be higher aspeople understand guaranteed issue?• Will private exchanges fill a market need?www.galen.org
    • Europeans moving towardpatient-centered care/decentralization• Consumerism• Value of private enterpriseand competition• Doctor-patient relationship• Decentralizeddecision-makingwww.galen.org
    • The future?• The global move towardconsumerism is real, drivenby greater patient demandfor more control overdecisions.• People will seek moreaffordable options outsidethe ACA’s centralizedcontrol.
    • A not-for-profithealth and tax policyresearch organization/GalenInstitutewww.galen.orgGrace-Marie TurnerGalen Institute703-299-8900gracemarie@galen.orgtwitter.com/GalenInstitutefacebook.com/GalenInstituteSubscribe to our free email alerts atwww.galen.org/subscribe